All details supplied to A Select Choice Introductions will be treated as strictly confidential.

Period of enrollment is as specified and is renewable ___________ Months

A Select Choice Introductions reserves the right to refuse or withdraw the enrolment of any person who exhibits undesirable behavior.

A recent photograph must be provided to enable visual identification of each client.

Two forms of positive identification in the form of a Passport or Birth Certificate, Drivers License, Citizenship Papers on enrollment, or if requested at any time.

The client consents to any investigation to allow A Select Choice to verify his/her identity.

Payments for membership must no fall behind. If they fall one month behind membership will be suspended and no introductions will be provided until payment is up- to- date.

The Client agrees to contact all persons whom he/she is introduced to, and return the introduction form each time a new contact is required.

All enquiries regarding enrollment must be directed to the following address: Complaints about other members or any other reason MUST be in WRITING and directed to:

The Manager Matching Department A Select Choice Suite 32 Stanhill Building 34 Queens Road Melbourne 3004 Telephone 03 98674000

The rules and conditions are for the benefit of all clients in A Select Choice Introductions to ensure that each client receives equal attention and consideration.

I agree to be bound by the rules and conditions of enrollment in A Select Choice Introductions and acknowledge a copy of conditions of service.

Applicant Signature: _________________ Membership Number______________

Consultant Signature: _________________ Consultants Number__________ Date______________

Special conditions relating to this membership:

I consent to the following details being published on the introduction form, in newspapers or on the A Select choice web site. This is mandatory to be accepted into any listing or free membership. My first name, age, marital status, height, build, education, employment catagory, interests, comments availability status, location and photograph.

Consultant signature______________________ Clients signature__________________________